ABSTRACT
Objective To explore the technique and clinical efficacy of retroperitoneoscopic nephrectomy (RN) at different anatomical plane for benign non-functioning kidneys. Method We retrospectively reviewed the clinical data of 84 patients who underwent RN for benign non-functioning kidneys from February 2010 to November 2016. Various anatomical plane was performed for differing etiology, image and plane, included radical nephrectomy (A group, n = 35), simple nephrectomy (B group, n = 27) and subcapsular nephrectomy (C group, n = 22). Clinical data and preoperative information was collected and analyzed. Result Nephrectomy was performed successfully in 84 patients. There are significantly longer mean operative time and more estimated blood loss in the C group than that in A group and B group (P < 0.05), however, postoperative hospital stay, complications and recovery time were significantly less in the three groups. There was longer mean operative time and more estimated blood in specific and nonspecific infection group compared with the other two groups (P < 0.05). Conclusion Retroperitoneoscopic nephrectomy, although challenging, is safe, reliable, and successful for treatment of benign non-functioning kidneys.Anatomical plane of avascular zone should be offered as the choice of modality to all patients with benign non-functioning kidney.
ABSTRACT
OBJECTIVE: To study the effects of dimethyltin chloride( DMT) on the activity of renal H~+K~+-ATPase( HKA)and Na~+K~+-ATPase( NKA) in SD rats. METHODS: i) In vitro experiment. Five specific pathogen free( SPF) healthy female SD rats were used. The kidney homogenates made with 0. 90% sodium chloride solution was added with DMT( mass concentration,1. 0 g/L) to make final concentrations of 0,1,25,125 and 625 mg/L respectively,then the HKA and NKA activities were detected by the enzyme-linked immunosorbent assay( ELISA). ii) In vivo experiment. Forty SPF healthy SD rats were divided into control group and exposure group,with 20 rats( 10 males and 10 females) in each group. The exposure group was given one-time intraperitoneal injection with DMT( 16. 000 mg / kg body weight),while the control group was given one-time intraperitoneal injection with same volume of 0. 90% sodium chloride solution. The rats were executed 1 and 24 hours after exposure. The kidney tissue was extracted to make kidney homogenates for determination of HKA and NKA activity by microplate reader. The blood from abdominal aorta was collected to measure the levels of serum K~+,Na~+and Cl-. RESULTS: i) In vitro experiment. The HKA activity was inhibited by DMT,and the effect of inhibition increased with the increase of DMT exposure dose( P < 0. 01),showing a dose-effect relationship. The DMT had no effect on NKA activity( P > 0. 05). ii) In vivo experiment. The body weight of rats at 24 hours time point in exposed group was lower than that in control group( P < 0. 01). The HKA activity of the kidney tissue in rats in exposed group was lower than that of control group( P < 0. 01). The NKA activity in kidney tissue of rats and the level serum K~+,Na~+and Cl-did not show statistical difference in main and interactive effects concerning treatment and exposure time( P > 0. 05). CONCLUSION: DMT could inhibit the HKA activity in kidney homogenates,but had no obvious effect on NKA activity.